Effect Of Propofol On Cardiovascular Stability In Hypertensive Patients Undergoing Cholesyctectomy Surgery

Abstract

Background

Propofol is a commonly used intravenous anesthetic due to its rapid onset and favorable recovery profile. However, its potential to reduce blood pressure and myocardial contractility can challenge cardiovascular stability, particularly in hypertensive patients undergoing surgery. Ensuring perioperative hemodynamic stability is critical to prevent complications and improve surgical outcomes.

Objective

To evaluate the effect of Propofol on cardiovascular stability in hypertensive patients undergoing elective cholecystectomy, focusing on perioperative fluctuations in blood pressure, mean arterial pressure, and heart rate.

Methodology

A cross-sectional study was conducted at Hayatabad Medical Complex, Peshawar over four months. A total of 120 hypertensive patients undergoing elective cholecystectomy were recruited using non-probability consecutive sampling. Inclusion criteria included patients aged 18–65 years with controlled hypertension who provided informed consent. Hemodynamic parameters (systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and heart rate (HR) were recorded at baseline (pre-induction), during Propofol induction, intraoperatively, and postoperatively using standardized monitoring equipment. Data were collected via a structured proforma and analyzed using SPSS version 27. Descriptive statistics summarized baseline characteristics, and inferential tests including paired t-tests, chi-square tests, and repeated measures ANOVA were applied. A p-value <0.05 was considered statistically significant.

Results

Of the 120 participants, 54 (45%) were male and 66 (55%) were female, with the majority aged 41–50 years. Propofol induction resulted in significant reductions in SBP (↓11.3%), DBP (↓13.6%), and MAP (↓13.2%), while HR showed mild decreases. Most patients remained hemodynamically stable intraoperatively, with only 15% experiencing transient hypotension and 13.3% requiring vasopressors. Arrhythmias were rare (13.3%) and mostly benign. Postoperative recovery demonstrated return to baseline values, indicating rapid cardiovascular stabilization.

Conclusion

Propofol provides effective cardiovascular stability in controlled hypertensive patients undergoing elective cholecystectomy. Although mild hypotension occurs, it is manageable with standard interventions. These findings support Propofol as a safe induction agent when combined with vigilant perioperative monitoring.